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525 NE 101 St (2)- - -' CLOSETS BATH Tu•S S HOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL POSTURES CONTK. LIST CHECK _ SEPTIC TANK SEWER CONN. DRAIN F IELD SOAKAGE PIT G TRAP SOLAR HEATER DM. WELL BPRKLR. S M SW IM POOL COM'R. LIST CHECK Permit No .N 1 1 443 Date..._.. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engine er t f e C - £mploeing Plumber's Name -D / ps p-- --4 - +~E: «'�� / s� s^ � - ptio Lot_ / 7 °'Y 1 / Num where woEk is to be performed -No State work to be performed and purpose of building (By Floors) giiki.- Q _ New Building._-.-._-- ._- .........._-. Remodeling—_._-. -_.---_-_-_- Addition -- ___-_._ Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT performed under this permit; and will post or cause to be posted for inspection on the site of the required by the Act. The undersigned agrees to employ only such sub -contr licensed by MLmi Shores Village. My Commission Expires (Si 2 �7 s 7 1 C� C No. v�'1 � Street. /VI / O / 2 subdivision.- _P�-- i'iij , v Beet .N _...1. 1... -. 7 • Ai.!V Repairs I/ No. of Stories Size Septic Tank_ -Type of Tank Feet of Drain Tile. D1zt. Feet of Tank or Drain Field from Well. .-- .-- ---- _. ....__ - -... Nature of Water Supply: City-Well. Size of Soakage Pit .Z� Notary Public, State of Florida Master Plumber. (Signed)- — -- — - - -y -- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and Ilrr com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worlr to be such public notice or notices as are work ' be , - • under this permit, as are STATE OF FLORIDA, 1 ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -- _......--- - -.... _ _...._._ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when wsei rwl sspectlon is ssadeltscars -ry by latP'oper soda, far Impaction. or faulty material and /or warl®aoship. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant e r 2 ^'1 ' i`/ PermitN Number 8 C' / 5'az s l, /6/s7' f'Z a J 7' PART II - STEM INSTALLATION INSPECTION AND Fl AL INSTALLATI APPROVAL- Installer i E 1 Tank Manufacturer N/ Proper tank legend: Yes/ No Tank material Tank level: Yes No Tankswatertight: Yes Pi7t- No Tank size gallons Proper tank outlet device: Yes 1 - No Manhole or marker to grade: Yes y/ No Length Width feet feet feet feet feet feet Total = ft Drainfield Trench /v/ic Systems located as permitted: Yes +r No Backfill or fill material as required: (Quality) Yes No Inspected by HRS—H Form 4016, Feb 85 (Obsoietes previous editions which may not be used) (Stock Number. 5744-002-4016-0) Length Width feet feet feet feet feet feet Total = ft PART III - FINAL NSTALLATION APPROVAL Date `) /- h- .nApproved by: -r E-- �e.-- -,-A- (�s-?) —'' gallons ` gallons Length 30 feet x/0.3 feet = • oo ft �aD feet= ft Proper No. drainlines: Yes / No Proper pipe separation: Yes No 3d Distribution box level: Yes Pp No Length feet x Average depth of drainfield gravel: /-Z inches Minimum depth of gravel -� inches Proper gravel size: Yes 7 No Gravel is suitable quality Yes " No Absorption Bed Systems including plumbing stub -outs installed at proper elevation: Yes LM No t Average depth to drainpipe invert from finished grade: inches Maximum depth: Inches (Quantity) Yes`• No Other findings: 6� co AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE Date /I- - - Note: Completed copies of this form will be provided to the applicant, installer and the building department. Page 2 of 2\ Permit No ( Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved phut' and specifications mud be kept at building during progress of work. Owner's Name and Address Liegistered Architect and/or Engineer 3mploying Plumber's Name A_ 1 _g_korie Xvic . No . street..114,Z1 Location and Legal Description Lot_ Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors)._ New Building Remodeling A Amount of Permit $ 0 STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT aL_Lii Ni( • No 5L Street.A/ el ). 4.7 Bloolt S street_ A./ 4 fe.4 ,57 ei_..)/1"( R _ ( Signed) Date 1 1_--11117 ddition. Repairs t,•.! No. of Stories Size Septic Tank_ of Tank__. Feet of Drain Tile. ___Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: of Soakage Pit ......... ....... Capacity Gals..._.. ........... The undersigned applicant for this building permit does hereby certify that he understands and accepts his Lions as an ernployer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent rupplement, and has t'. plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed ly him in the wcrk co bt. performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pul notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on o be perfo J.r,„3ca this puinit, as aro licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well 'mown, and who, being by me first duly sworn, upon oath deposes suid says that he is the of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by lain. stated are true. Notary Public, State of Florida Plumbing Inspector. umber. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is mede.necessary by improper notice for inspection, or faulty materials and/or worinanship. CLOSETS BATH TUBS SHOWERS LAVA. Tomlin SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT• N5 TOTF.L F I XTURE• Corm. Liar CHECK ..■.... SEPTIC TANK SEWER CONN. DRAIN rime SOAKAGE PIT G TRAP SOLAR H Damp WELL SPRKLR. S SW IMO POOL CONTR. LIST CHECK Permit No ( Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved phut' and specifications mud be kept at building during progress of work. Owner's Name and Address Liegistered Architect and/or Engineer 3mploying Plumber's Name A_ 1 _g_korie Xvic . No . street..114,Z1 Location and Legal Description Lot_ Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors)._ New Building Remodeling A Amount of Permit $ 0 STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT aL_Lii Ni( • No 5L Street.A/ el ). 4.7 Bloolt S street_ A./ 4 fe.4 ,57 ei_..)/1"( R _ ( Signed) Date 1 1_--11117 ddition. Repairs t,•.! No. of Stories Size Septic Tank_ of Tank__. Feet of Drain Tile. ___Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: of Soakage Pit ......... ....... Capacity Gals..._.. ........... The undersigned applicant for this building permit does hereby certify that he understands and accepts his Lions as an ernployer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent rupplement, and has t'. plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed ly him in the wcrk co bt. performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pul notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on o be perfo J.r,„3ca this puinit, as aro licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well 'mown, and who, being by me first duly sworn, upon oath deposes suid says that he is the of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by lain. stated are true. Notary Public, State of Florida Plumbing Inspector. umber. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is mede.necessary by improper notice for inspection, or faulty materials and/or worinanship. Permit No._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Joe Callahan __ _ N _ No.� Street 525 N . E. 101 St. Registered Architect and /or Engineer _____ ____.— .___._______._____. ___-- _ — ___---T__------- �pY,o mploying Plumber's Name Sun Gold__ Septic _Tank_, In c. No.___ -.__ __.__._.� Street_PO Box 7267_,____Miami Location and Legal Description Lot -____._______ _ __.___ _ _ Block __. Subdivision Street and Number where work is to be performed—No. _ 525 N • E • 101 Street State work to be performed and purpose of building (By Floors ________ 32 Ft. Dra inf i e ld Relay New Building_____ __ ___ Remodeling ____.__.._...____._.__ Addition Repairs No. of Stories Size Septic Tank , Type of Tank. Capacity Gals Feet of Drain Tile 32 _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._____ ___________________ _ ____Size of Soakage Pit Amount of Permit $ ( Signed) - 4 < Jlumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors . ub- tractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on th e e r such publi notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contract s, on �•r performed nder this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 12/30/63 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida mber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBE OW SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK - _ .... Permit No._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Joe Callahan __ _ N _ No.� Street 525 N . E. 101 St. Registered Architect and /or Engineer _____ ____.— .___._______._____. ___-- _ — ___---T__------- �pY,o mploying Plumber's Name Sun Gold__ Septic _Tank_, In c. No.___ -.__ __.__._.� Street_PO Box 7267_,____Miami Location and Legal Description Lot -____._______ _ __.___ _ _ Block __. Subdivision Street and Number where work is to be performed—No. _ 525 N • E • 101 Street State work to be performed and purpose of building (By Floors ________ 32 Ft. Dra inf i e ld Relay New Building_____ __ ___ Remodeling ____.__.._...____._.__ Addition Repairs No. of Stories Size Septic Tank , Type of Tank. Capacity Gals Feet of Drain Tile 32 _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._____ ___________________ _ ____Size of Soakage Pit Amount of Permit $ ( Signed) - 4 < Jlumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors . ub- tractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on th e e r such publi notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contract s, on �•r performed nder this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 12/30/63 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida mber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspection, or faulty materials and/or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address__ Registered Architect and /or Engineer — __ - -___ _____ _ Employing Plumber's Name___ __ J 4 LCL-- _-_Za _bi /�,.__ No._ - - - -- _-- - - - --_ _ Street_ Location and Legal Description Block Subdivision Street and Number where work is to be performed -No / Street State work to be performed and purpose of building (By Floors)____ -- -------------- .---- -_ - - New Building __ Remodeling..__ _ —___ Addition______. Repairs Size Septic Tank_._ - - -_ _ , Pg Type of Tank -2157 Feet of Drain Feet of Tank or Drain Field from Well Nature of Water Supply: City- Well.____-______ ___________ ______- ........... __— ___.Size of Soakage Pit Amount of Permit $ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supplement, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the it of the wo such p blic notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors ony work to perfo a under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above des lied construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stn d are true. APPLICATION FOR PLUMBING PERMIT No. -- - - - - - -- Street. ( Signed) Date _ No. of Stories... .... . .......... Capacity Gals CP 0 C My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKI NG FOUNT'N8 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL I - - - -- LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address__ Registered Architect and /or Engineer — __ - -___ _____ _ Employing Plumber's Name___ __ J 4 LCL-- _-_Za _bi /�,.__ No._ - - - -- _-- - - - --_ _ Street_ Location and Legal Description Block Subdivision Street and Number where work is to be performed -No / Street State work to be performed and purpose of building (By Floors)____ -- -------------- .---- -_ - - New Building __ Remodeling..__ _ —___ Addition______. Repairs Size Septic Tank_._ - - -_ _ , Pg Type of Tank -2157 Feet of Drain Feet of Tank or Drain Field from Well Nature of Water Supply: City- Well.____-______ ___________ ______- ........... __— ___.Size of Soakage Pit Amount of Permit $ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supplement, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the it of the wo such p blic notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors ony work to perfo a under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above des lied construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stn d are true. APPLICATION FOR PLUMBING PERMIT No. -- - - - - - -- Street. ( Signed) Date _ No. of Stories... .... . .......... Capacity Gals CP 0 C My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No 7z3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittecl'for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ` Owner's Name and Address_ Nchs-4. Registered Architect and/or Engineer_„___ ./ _ :_ ._ __ Employing Plumber's Name Location and Legal Description ....... Nature of Water Supply: City —Well. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) _ Date No: J) _ :16) Street-_ -- _- Street _ -3 jt) _ --L ke Subdivision _- --- _------ --_--- Street and Number where work is to be performed —No 5 2' Street__ 4/ State work to be performed and purpose of building (By Floors) New Building Remodeling___ ________ Addition Repairs No. of Stories Size Septic Tank ------------- ____ -- -Type of Tank Feet of Drain Tile -_Dist. Feet of Tank or Drain Field from Well _.Size of Soakage Pit Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he und6rstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires (Signed). Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK 0- '/ ` -- {�1 yn, t Permit No 7z3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittecl'for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ` Owner's Name and Address_ Nchs-4. Registered Architect and/or Engineer_„___ ./ _ :_ ._ __ Employing Plumber's Name Location and Legal Description ....... Nature of Water Supply: City —Well. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) _ Date No: J) _ :16) Street-_ -- _- Street _ -3 jt) _ --L ke Subdivision _- --- _------ --_--- Street and Number where work is to be performed —No 5 2' Street__ 4/ State work to be performed and purpose of building (By Floors) New Building Remodeling___ ________ Addition Repairs No. of Stories Size Septic Tank ------------- ____ -- -Type of Tank Feet of Drain Tile -_Dist. Feet of Tank or Drain Field from Well _.Size of Soakage Pit Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he und6rstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires (Signed). Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspection, or faulty materials and /or workmanship.